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Target groups for the prevention of late – life anxiety

Trimbos Institute (Netherlands Institute of Mental Health and Addiction), Utrecht, and Department of Clinical Psychology, Vrije Universiteit, Amsterdam

Hannie Comijs

Department of Psychiatry, Free University Medical Centre, Amsterdam

Robert Schoevers

Mentrum Mental Health Care, Amsterdam

Pim Cuijpers

Trimbos Institute, Utrecht, and Department of Clinical Psychology, Free University, Amsterdam

Dorly Deeg

Department of Psychiatry, Free University Medical Centre, Amsterdam

Aartjan Beekman

Trimbos Institute, Utrecht, and Department of Psychiatry, Free University Medical Centre, Amsterdam, The Netherlands

Correspondence: Dr Filip Smit, Trimbos Institute, Netherlands Institute of Mental Health and Addiction, PO Box 725, 3500 AS, Utrecht, The Netherlands, Tel: + 31 30 2959254, fax: + 31 30 2971111, email: FSmit{at}Trimbos.NL

Declaration of interest None.

Background Anxiety disorders in older people are highly prevalent, yet there is little evidence to guide targeted prevention strategies.

Aims To identify subgroups at increased risk of developing anxiety in later life.

Method Anxiety was measured with the Hospital Anxiety and Depression anxiety sub-scale in 1931 people aged 55-85 years followed over 3 years. Risk factors were identified that had a high combined attributable fraction, indicative of substantial health gains when the adverse effect of the risk factors can be contained.

Results Factors significantly associated with increased risk of developing anxiety included sub-threshold anxiety, depression, two or more chronic illnesses, poor sense of mastery, poor self-rated health and low educational level.

Conclusions The identified risk groups are small, thus providing prevention with a narrow focus, and health gains are likely to be more substantial than in groups not exposed to these risk factors. Nevertheless, more research is needed to produce evidence on target groups where prevention has optimal impacts.